In the American article, written by Harvey Fineberg, M.D., Ph.D, and published in the New England Journal of Medicine (@nejm), the attributes mentioned are

affordability

acceptability

adaptability

…and adaptability is not mentioned in the context of a changing environment or external forces. Climate change or carbon emissions aren’t mentioned at all.

because health and health care needs are not static (i.e., a health system must respond adaptively to new diseases, changing demographics, scientific discoveries, and dynamic technologies in order to remain viable).

In the European article, written by Dr. Frances Mortimer and published in Clinical Medicine (Royal College of Physicians), the attributes are

The Mortimer article feels more “health” focused – that health care is a means, not an end:

The public funding of medical care inevitably diverts resources from health-sustaining investment in education, social welfare and housing. In return, health services are asked to demonstrate a measure of cost effectiveness. The provision of medical care, however, incurs not just financial costs, but also significant environmental ones, in the form of greenhouse gas emissions, pollution of air and water, changes to land use, and so on. This could be viewed as spending eco- logical capital, which is equally essential to population health.

This leads me to believe, that in this country, we are just beginning to understand all of the determinants of health, and the role of our amazing health system in impacting change, far beyond our medical offices or hospitals.

Or as Gary Cohen famously said as he was being celebrated at The White House: